Music evoked autobiographical memories in people with behavioural variant frontotemporal dementia.

Music is highly efficient at evoking autobiographical memories in both healthy and neurological populations. Music evoked autobiographical memories (MEAMs) are preserved in people with Alzheimer's Dementia (AD), and occur at the same frequency as in healthy people. To date there has been no investigation of the integrity of MEAMs in people with non-AD dementia. This study provides the first characterisation of the frequency and specificity of MEAMs and photo evoked autobiographical memories (PEAMs) in 6 people with Behavioural variant frontotemporal dementia (Bv-FTD). We found significantly reduced frequency and specificity of MEAMs and PEAMs in people with Bv-FTD compared with healthy elderly. This supports the known decline in autobiographical memory function in this population, and the integral role of medial frontal regions in the retrieval of MEAMs. Our findings highlight that the mnemonic effects of music vary between people with different types of dementia, which has implications for dementia care.

Statistical analysis plan for the Recovery-focused Community support to Avoid readmissions and improve Participation after Stroke randomised controlled clinical trial.

BACKGROUND: Unplanned hospital presentations may occur post-stroke due to inadequate preparation for transitioning from hospital to home. The Recovery-focused Community support to Avoid readmissions and improve Participation after Stroke (ReCAPS) trial was designed to test the effectiveness of receiving a 12-week, self-management intervention, comprising personalised goal setting with a clinician and aligned educational/motivational electronic messages. Primary outcome is as follows: self-reported unplanned hospital presentations (emergency department/admission) within 90-day post-randomisation. We present the statistical analysis plan for this trial. METHODS/DESIGN: Participants are randomised 1:1 in variable block sizes, with stratification balancing by age and level of baseline disability. The sample size was 890 participants, calculated to detect a 10% absolute reduction in the proportion of participants reporting unplanned hospital presentations/admissions, with 80% power and 5% significance level (two sided). Recruitment will end in December 2023 when funding is expended, and the sample size achieved will be used. Logistic regression, adjusted for the stratification variables, will be used to determine the effectiveness of the intervention on the primary outcome. Secondary outcomes will be evaluated using appropriate regression models. The primary outcome analysis will be based on intention to treat. A p-value ≤ 0.05 will indicate statistical significance. An independent Data Safety and Monitoring Committee has routinely reviewed the progress and safety of the trial. CONCLUSIONS: This statistical analysis plan ensures transparency in reporting the trial outcomes. ReCAPS trial will provide novel evidence on the effectiveness of a digital health support package post-stroke. TRIAL REGISTRATION: ClinicalTrials.gov ACTRN12618001468213. Registered on August 31, 2018. SAP version 1.13 (October 12 2023) Protocol version 1.12 (October 12, 2022) SAP revisions Nil.

Screening, prevention, and management of patients with poststroke depression in a tertiary hospital in China: a best practice implementation project.

INTRODUCTION: Poststroke depression (PSD) is common but insufficiently addressed by health professionals, and management is not always evidence-based. OBJECTIVES: This evidence implementation project aimed to improve adherence to evidence-based practice for screening, prevention, and management of patients with PSD in the neurology ward of the Fifth Affiliated Hospital of Zunyi Medical University, China. METHODS: This project was based on the JBI methodological approach and was conducted in three phases, from January to June 2021: a baseline audit, implementation of strategies, and a follow-up audit. We utilized the JBI Practical Application of Clinical Evidence System software and the Getting Research into Practice tools. Fourteen nurses, 162 stroke patients, and their caregivers participated in this study. RESULTS: The results of the baseline audit showed that compliance with evidence-based practice was poor, with 3/6 criteria showing 0% adherence and the other three audit criteria showing 5.7, 10.3, and 49.4% adherence, respectively. Through feedback to nurses regarding the baseline audit results, the project team identified five barriers and adopted a battery of strategies to overcome these barriers. The follow-up audit revealed significantly enhanced outcomes across all the best practice criteria, and the compliance of each criterion reached at least 80%. CONCLUSION: The implementation program designed to screen, prevent, and manage PSD in a tertiary hospital in China improved nurses' knowledge and compliance with evidence-based management of PSD. Further testing of this program in more hospitals is needed.

Why is music therapeutic for neurological disorders? The Therapeutic Music Capacities Model.

Music has cognitive, psychosocial, behavioral and motor benefits for people with neurological disorders such as dementia, stroke, Parkinson's disease (PD) and Autism Spectrum Disorder (ASD). Here we discuss seven properties or 'capacities' of music that interact with brain function and contribute to its therapeutic value. Specifically, in its various forms, music can be engaging, emotional, physical, personal, social and persuasive, and it promotes synchronization of movement. We propose the Therapeutic Music Capacities Model (TMCM), which links individual properties of music to therapeutic mechanisms, leading to cognitive, psychosocial, behavioral and motor benefits. We review evidence that these capacities have reliable benefits for people with dementia, stroke, PD and ASD when employed separately or in combination. The model accounts for the profound value that music affords human health and well-being and provides a framework for the development of non-pharmaceutical treatments for neurological disorders.

A 'Music, Mind and Movement' Program for People With Dementia: Initial Evidence of Improved Cognition.

BACKGROUND: Music is being increasingly used as a therapeutic tool for people with dementia. Research has uncovered several qualities of music that are responsible for its beneficial effects. Based on the identification of seven therapeutic capacities of music, we devised the Music, Mind, and Movement (MMM) program and evaluated whether it had therapeutic benefit for people with dementia (various types) in the areas of cognition, mood, identity, and motor fluency. METHODS: The MMM program involved seven 45-min weekly group sessions, and individual 15-min "booster" sessions. Twenty people with mild to moderate dementia participated. Group 1 (n = 10) completed the MMM program first and Group 2 (n = 10) acted as a wait list control for 7 weeks, receiving standard care and completing the MMM program after the first group. Assessments of global cognition (Addenbrooke's Cognitive Examination, ACE-III), mood (Geriatric Depression Scale short form), identity ('I am' task), and fine motor skills (9-Hole peg task) were conducted at baseline (T1), time 2 (T2, post treatment), and time 3 (T3, 1 month post MMM program). RESULTS: Within group comparisons were conducted with 12 participants from the MMM program and 10 participants receiving standard care. Global cognition (total ACE-III score) improved in 8/12 participants after the MMM program, whilst it decreased in 8/10 participants after the period of standard care. MMM participants showed increases in ACE-III subdomain scores of attention (p = 0.007) and verbal fluency (p = 0.056). CONCLUSION: Our preliminary findings suggest that the MMM program may improve cognition, particularly verbal fluency and attention, in people with dementia.

Characterization of Music and Photograph Evoked Autobiographical Memories in People with Alzheimer's Disease.

BACKGROUND: Music evoked autobiographical memories (MEAMs) have been documented in people with Alzheimer's disease (AD), but it is unclear whether music is more effective than other familiar stimuli at evoking memories. OBJECTIVE: To explore the frequency and specificity of memories in response to famous songs compared with photographs of famous events (photograph evoked autobiographical memories, PEAMs), and whether stimuli from the period of the reminiscence bump (10-30 years of age) were more likely to elicit memories. METHODS: 10 participants with AD and 10 aged-matched healthy elderly people reported memories following exposure to 2 songs (longest time at number one in Australian music charts) and 2 photographs (of prominent famous events) from each decade from 1930 to 2010. RESULTS: PEAMs were more frequent than MEAMs in healthy elderly (p < 0.05), but no such differences were observed among people with AD. There was no difference in the frequency of MEAMs between groups, but people with AD showed a significant decline in the frequency of PEAMs. In both groups, MEAMs were typically less specific than PEAMs and comprised semantic knowledge or repeated/extended events. Stimuli from when participants were aged 10-30 years triggered more frequent memories compared with stimuli from later decades, but this was only statistically significant for MEAMs. CONCLUSION: Our findings indicate a preserved mnemonic effect of music relative to pictures in this patient population, corroborating suggestions that MEAMs represent an island of preservation during the progression of AD.

Impaired socio-emotional processing in a developmental music disorder.

Some individuals show a congenital deficit for music processing despite normal peripheral auditory processing, cognitive functioning, and music exposure. This condition, termed congenital amusia, is typically approached regarding its profile of musical and pitch difficulties. Here, we examine whether amusia also affects socio-emotional processing, probing auditory and visual domains. Thirteen adults with amusia and 11 controls completed two experiments. In Experiment 1, participants judged emotions in emotional speech prosody, nonverbal vocalizations (e.g., crying), and (silent) facial expressions. Target emotions were: amusement, anger, disgust, fear, pleasure, relief, and sadness. Compared to controls, amusics were impaired for all stimulus types, and the magnitude of their impairment was similar for auditory and visual emotions. In Experiment 2, participants listened to spontaneous and posed laughs, and either inferred the authenticity of the speaker's state, or judged how much laughs were contagious. Amusics showed decreased sensitivity to laughter authenticity, but normal contagion responses. Across the experiments, mixed-effects models revealed that the acoustic features of vocal signals predicted socio-emotional evaluations in both groups, but the profile of predictive acoustic features was different in amusia. These findings suggest that a developmental music disorder can affect socio-emotional cognition in subtle ways, an impairment not restricted to auditory information.